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General NPI Number Information
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NPI Number | 1083756472
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Entity Type | Individual
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Provider Name | CHARIS W PEEK NP
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Gender | Female
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Dates
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Enumeration Date | 02/13/2007
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Last Update Date | 08/03/2011
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Provider Practice Location Address
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Address Line | 2207 MOODY RIDGE RD
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City | SCOTTSBORO
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State | AL
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Zip | 35768-4113
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Country | US
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Telephone | 256-259-1327
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Fax |
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Provider Business Mailing Address
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Address Line | 161 COUNTY ROAD 668
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City | PISGAH
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State | AL
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Zip | 35765-7170
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Country | US
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Telephone | 256-657-4370
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 1-087501
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License Number State | AL
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